Abstract WP138: Delirium Is Associated With Higher Rates Of 90-day Hospital Readmission Among Patients With Primary Intracerebral Hemorrhage
| Autor: | Thomas Potter, Jennifer Meeks, Abdulaziz T Bako, Alan Pan, Jonika Tannous, Carnayla Johnson, Eman Baig, Wamda Ahmed, Vivek Misra, Farhaan S Vahidy |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Stroke. 53 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/str.53.suppl_1.wp138 |
| Popis: | Background: Delirium in-hospital (DIH) results in poor in-patient outcomes. However, it’s longer-term effects among intracerebral hemorrhage (ICH) patients are not well characterized. We sought to evaluate the association between DIH and 90-day readmission (RA) among primary ICH patients. Method: Clinical, imaging and outcomes data, from May 2016 to June 2021, were obtained from the Neurological Outcomes Registry for ICH (NEURO-RICH) ; an informatics pipeline across 7 comprehensive and primary stroke centers which implement protocolized delirium assessments via 4AT / CAM-ICU scales. Demographic (age, sex, race, ethnicity, marital status), Glasgow Coma Scale (GCS), systolic and diastolic blood pressure (S/DBP), sepsis, systemic inflammatory response syndrome, and comorbidity data were analyzed. Survival analysis for time-to-90-Day RA was performed with death modeled as a competing risk. Sub hazard ratios (SHR) and 95% confidence intervals (CI) are reported. Subgroup with imaging data (ICH score and cerebral small vessel disease) was analyzed. Results: Final analyses included 1,434 ICH patients (mean age: 66.0 years, 47.2% female, 24.8% non-Hispanic Black, 19.9% Hispanic, median GCS: 13.2, SBP: 163 mmHg). In the fully adjusted model, DIH was significantly associated with higher rates of 90-Day RA (SHR, CI: 2.24, 1.04 - 4.81) (Figure 1A). Anticoagulant therapy (1.36, 1.03 - 1.80), hypertension (1.95, 1.38 - 2.74), diabetes (1.13, 1.09 - 1.17), and Charlson Comorbidity Index (1.08, 1.04 - 1.13) were also independently associated with 90-Day RA (SHR, CI reported). In the imaging subgroup of 523 patients, DIH retained independent association with 90-Day RA (SHR: 3.94 [1.37 - 11.36]) (Figure 1B). Discussion: In addition to traditional predictors of poor outcomes among ICH patients, DIH demonstrated strong and independent association with 90-day RA. Screening, identification, and active management of DIH is critical to reduce long-term disease burden of ICH. |
| Databáze: | OpenAIRE |
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